AB0333 PERIODONTITIS AND DISEASE ACTIVITY IN RHEUMATOID ARTHRITIS: A CASE CONTROL STUDY
Authors: A. Ben Salem, M. Brahem, C. Baccouche, R. Sarraj, O. Jomaa, H. Hachfi, Y. Mohamed
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Different studies have estimated a higher risk of dental and periodontal abnormalities in patients with rheumatoid arthritis (RA), but it is often under-diagnosed. <h3>Objectives</h3> In this context, we conducted this study, whose objectives were to evaluate the frequency and the type of oral and periodontal abnormalities in patients with RA compared to control subjects and to determinate the predictive factors of the periodontal disease. <h3>Methods</h3> This is a case control study conducted during the period between July 2020 and June 2022. The oral and osteoarticular examination was performed for each patient. The different dental and periodontal indices were calculated: CAO index, plaque index (PI) and gingival index (GI). <h3>Results</h3> Sixty patients diagnosed with RA according to the ACR/EULAR 2010 classification and 71 control patients were included. The mean age of patients with RA was 51.5 ± 12.4 years [21-78 years] and that of the control group was 47.2 ±12.8 years [22-74 years]. The oral examination showed poor oral hygiene based on the plaque index (PI). The frequency of moderate to abundant plaque accumulation (PI≥ score 2) was comparable between the two groups with non-significant difference (91.7% versus 94.4%; p=0.5). Regarding dental caries, the median CAO was greater in the RA group than in the control group with a significant difference (5 [1-10] versus 2 [0-5]; p&lt;0.01). The mean numbers of missing and decayed teeth in RA patients were higher than those found in controls (3.3±4.6 versus 2±3.06; 1.9±2.3 versus 1.39±2.2 respectively). Analysis of the superficial periodontal status showed that 88.3% of RA patients had gingivitis compared with 90.1% of controls. The mean gingival index was 1.72±0.8 in RA group versus 1.76±0.7 in control group without a significant difference. As for the alteration of the deep periodontium, 53.3% had periodontal pockets and/or gingival recessions compared to 19.8% of controls with a statistically significant difference (p=0.01). This involvement in RA patients was significantly correlated with disease activity DAS 28 and the importance of the CRP level (p=0.02, p=0.03 respectively). Tooth mobility was experienced by 28.4% of RA patients versus 11.2% of controls with a significant difference between the two groups (p=0.01). <h3>Conclusion</h3> Our study confirmed the frequency of periodontitis and dental caries in RA patients compared to controls and their association with disease activity. Hence the importance of early detection and management of these abnormalities in order to improve the disease activity and the quality of life of our patients. <h3>References</h3> [1] Mercado F, Marshall RI, Klestov AC, Bartold PM. Is there a relationship between rheumatoid arthritis and periodontal disease? J Clin Periodontol 2000. [2] Jayatilake JA, Rajapakse S, Weerasinghe IE, Wanigasekara P, Vasanthathilaka J. Oral hygiene and periodontal status in a group of patients with rheumatoid arthritis. Indian J Rheumatol 2011. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.